BIG program fights Parkinson's

Patients see improvements in walking, balance, pain level

Jan. 17, 2014
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On With Life physical therapist Gail McGaughy, left, looks on as Connie Ramseyer, center, of Altoona, and Cheryl Weber, right, of Runnells, exercise as part of the Lee Silverman Voice Treatment BIG program. The new program is offered to people with Parkinson's disease at the On With Life facility in Ankeny. / Bill Neibergall/The Register

Written by

Estela Villanueva-Whitman

Special to The Register

LSVT: BIG and LOUD

Crissanka Christadoss, coordinator of the Iowa Parkinson Disease Information and Referral Center, said families have inquired about physical therapists in the past, so LSVT BIG will now be another option for them to consider in the metro area. Another Parkinson’s-specific class, Delay the Disease, focuses more on exercise, she noted. The LSVT BIG program is intensive and requires quite a time commitment — four, one-hour sessions for four weeks. If folks aren’t quite ready for the programs or can’t withstand the intensity, therapists can offer more traditional rehabilitation. Assessments can determine that. Depending on needs, participants can sign up for the BIG and LOUD programs individually, or complete both programs at the same time, Miller said. LSVT is offered at a few other locations in Iowa. Fifteen clinicians are certified to offer BIG and nearly 50 Iowa speech therapists offer LOUD. For a list of LSVT programs in Iowa, go to www.lsvtglobal.com. Educational sessions for Lee Silverman Voice Training BIG and LOUD are set for 1 p.m. or 4 p.m. on Feb. 4 at On With Life, 715 S.W. Ankeny Road, Ankeny. RSVP by calling 515-289-9662 or go to www.onwithlife.org.

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Connie Ramseyer first noticed difficulty writing. She felt fatigued, found her movements slow and began having tremors in her left leg and hand. In 2012, she was diagnosed with Parkinson’s disease, a progressive movement disorder.

“I was afraid to walk by myself. The spring before I was diagnosed I was walking and fell and couldn’t understand why. I think now maybe it was because of that. I was getting more ‘weavy’ at one point. You just don’t have balance,” said Ramseyer, of Altoona.

Cheryl Weber of Runnells also had tremors in her right leg and was diagnosed in 2008, although she’d had symptoms for three years. She, too, had troubles writing and began to see a neurologist for Parkinson’s.

The women knew each other through church and became better acquainted when they discovered both were living with the same disease. When they heard about a new program at On With Life that could improve mobility and movement, they signed up together.

For four weeks, they carpooled four days a week to the sessions, one waiting patiently while the other received one-on-one therapy through the Lee Silverman Voice Treatment BIG program, also known as LSVT BIG.

By learning a series of large amplitude, or bigger, whole-body movements, they began to improve their balance and coordination and become more confident.

About a dozen folks completed the program at On With Life last fall, and more educational sessions are planned for Feb. 4. The center is also adding LSVT LOUD, focusing on vocal loudness with a speech therapist. A soft voice, as well as small handwriting and rigidity are all characteristics of Parkinson’s.

Movement

Both Ramseyer and Weber saw noticeable improvements through the BIG program. While a change in medication helped her handwriting abilities, Ramseyer said the exercises helped her walking and gait.

“I have much better movement. I can walk fast enough that my husband says ‘she goes off and leaves me,’ where before I was lagging behind all the time,” said Ramseyer, 65.

She’s also able to lift her dinner plates into a cabinet, something that she struggled with prior to the program.

Weber, 61, a retired nurse, said she has less pain and walks more evenly. Her memory is clearer and her handwriting has also improved. She continues to do the exercises first thing in the morning because she knows activity can help slow the progression of the disease.

“I don’t think I’ve missed a day since we left the program,” she said.

With the new therapies, On With Life, traditionally known for brain injury rehabilitation, is expanding its outpatient neuro rehabilitation offerings to better serve the community. Physical therapist Gail McGaughy joined the facility a year ago and was already certified in LSVT BIG. In researching the idea, staffers realized there were limited options in the Parkinson’s community.

“It goes with the mission of addressing the neurological condition and being able to serve people in the community and make a difference in their lives,” said Tammy Miller, outpatient office manager.

McCaughy and occupational therapist Jess Borysiewicz work with participants to provide a whole-person perspective. Exercises are specific for making big, big movements, McGaughy said, demonstrating part of the routine with Ramseyer and Weber.

Using whole-body movements, participants practice activities such as sit to stand, rock and reach, and stepping forward, sideways and backwards. They can also set personal goals. The therapy doesn’t work on tremors, Borysiewicz said, but targets reduced, small movements characteristic of those with Parkinson’s, as well as balance and coordination.

Recalibrate

“We’re trying to get the body to move in these over-exaggerated movements to kind of recalibrate the system so it’s moving at appropriate sizes,” he said.

Participants see improvement in walking speed, walking independence, as well as independent activities that require dexterity, such as putting on clothes or a coat. Quality of movement, such as walking with more normal movement patterns, also improves, he said.

Therapists conduct assessments at the start and end of the four weeks and some participants have shown dramatic improvement.

“It gives people a tool that they’re in charge of — they feel empowered about the process,” Borysiewicz said.